Faculty Scholarship Chair Sign-off
John W. Ruscito Scholarship
Instructions: Complete this form, sign and date it, and return the form along with ALL the scholarship applications to: Geraldine Peixoto, CCRI Foundation, Flanagan Campus. Upon receipt of all the applications and the sign-off form, the Office of Institutional Advancement will process the scholarship award within two weeks and mail the check to the selected recipient.
Name___________________________________________ Student I.D. #______________________
Address___________________________________ City__________________ State ____ Zip_______
Telephone_______________________________________ email_______________________________
1. Is the selected recipient a Computer Studies student? Yes__ No__
2. Is the selected recipient a F-T or P-T student attending CCRI? F-T__ P-T__>
3. Is the selected recipient continuing his/her education at CCRI next semester? Yes__ No__
4. Has preference been given to the following criteria: Students with disabilities who have matriculated in the Computer Studies Degree Programs? Yes__ No__
5. Students who are enrolled in Computer Studies courses? Yes__ No__
6. Computer Studies students who demonstrate financial need? Yes__ No__
7. Does the selected recipient demonstrate financial need? Yes__ No__
8. Are two (2) letters of recommendation from CCRI Computer Studies faculty/staff attached?
Yes__ No__
9. Has the selected recipient fully completed the application form? Yes__ No__
10. Did the selected recipient submit his/her application on or before October 1? Yes__ No__
11. The selected recipient meets all the scholarship eligibility requirements. Yes__ No__
Comments:
How many applications were received? _____
Who was on the selection committee
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Computer Studies and Information Processing
Department Chair’s Signature / Date
